Part 1 of our chat, which appeared last week at this time, can be found in the podcast archive. All ya have to do is use the site’s search function in the sidebar to your right; type in Podcast #186 and PRESTO! But don’t forget the #sign when you do your search.

Aunt Becky will also share more fruit of her Erotic Mind. We’ll learn why vacation sex is the best sex there is.

Got a question or a comment? Wanna rant or rave? Or maybe you’d just like to talk dirty for a minute or two. Why not get it off your chest! Give Dr Dick a call at (866) 422-5680.

DON’T BE SHY, LET IT FLY!

One last thought, I hope you’re also following my two other interview series, which appear on Wednesdays. One is called Sex EDGE-U-cation — I converse with prominent practitioners, educators and advocates of unconventional sexual expressions and lifestyles. And we investigate the world of fetish sex and kink. The other is called SEX WISDOM — here I chat with researchers, educators, clinicians, pundits and philosophers who are making news and reshaping how we look at our sexual selves. I can assure you that these conversations will be well worth the time you spend with us.

Look for all my podcasts on iTunes. You’ll find me in the podcast section, obviously. Just search for Dr Dick Sex Advice. And don’t forget to subscribe. I wouldn’t want you to miss even one episode.

It isn’t just Anthony Weiner: There is a big, noisy conversation going on about sex and porn addiction, as a couple quick Googlesearches will readily reveal. Naturally, that conversation has brought with it a growing market for counselors and even clinics specifically oriented toward treating these problems.

The problem is, many sex researchers don’t think sex and porn addiction are useful, empirically backed frameworks for understanding certain compulsive forms of sexual behavior. This has led to a rather fierce debate in some quarters, albeit one the average news consumer is probably unaware of.

Last week, the skeptics won an important victory: The American Association of Sexuality Educators, Counselors, and Therapists, which is the main professional body for those professions, has come out with a position statement arguing that there isn’t sufficient scientific evidence to support the concepts of porn and sex addiction. “When contentious topics and cultural conflicts impede sexual education and health care,” begins the statement, which was sent out to the organization’s members last week, “AASECT may publish position statements to clarify standards to protect consumer sexual health and sexual rights.”

It continues:

AASECT recognizes that people may experience significant physical, psychological, spiritual and sexual health consequences related to their sexual urges, thoughts or behaviors. AASECT recommends that its members utilize models that do not unduly pathologize consensual sexual problems. AASECT 1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge. Therefore, it is the position of AASECT that linking problems related to sexual urges, thoughts or behaviors to a porn/sexual addiction process cannot be advanced by AASECT as a standard of practice for sexuality education delivery, counseling or therapy.

AASECT advocates for a collaborative movement to establish standards of care supported by science, public health consensus and the rigorous protection of sexual rights for consumers seeking treatment for problems related to consensual sexual urges, thoughts or behaviors.

David Ley, an Albuquerque clinical psychologist whose whose book The Myth of Sex Addiction likely gives you a sense of his views on the subject, and who reviewed the statement for AASECT prior to its publication, described this as “kind of a big deal.” “It hits the credibility of sex-addiction therapists kind of between the legs frankly,” he said in an email. “These are clinicians who claim to [work on] sexuality issues, and the main body of sex therapist says that they are not demonstrating an adequate understanding of sexuality itself.”

Back in August, after the latest Weiner scandal broke, Ley laid out in an email why, even in such an extreme case, describing the disgraced former representative as a “sex addict” isn’t a helpful approach:

Ley’s basic argument is that that “sex addiction” isn’t well-defined, is quite scientifically controversial, and in recent decades has been increasingly used to explain a broad range of bad behavior on the part of (mostly) men. But in a sense, this robs men of their agency, of the possibility that they can control their compulsions and put them in a broader, more meaningful psychological context. “Sex addiction,” in this view, is a lazy and easy way out. […] Someone like Weiner, Ley explained, could obviously “benefit from learning to be more mindful, conscious, and less impulsive in his sexual behaviors. But those are issues resolved by helping him, and others, to become more mindful, conscious, and intentional in his life as a whole.” When you single out sex addiction as the source of the problem rather than taking this more holistic approach, Ley argued, it “ignores the fact that sex is always a complex, overdetermined behavior and that sex is often used by men to cope with negative feelings. Is Weiner getting the help he needs in his career, personal life, and relationship? Does he have other ways to try to make himself feel attractive and valued? Those are the questions that this latest incident raises. Sadly, calling him a sex addict ignores all of these much more important concerns.”

Weiner might not be the most sympathetic figure, but if Ley and the AASECT are correct, many sex-and porn-addiction clinics and clinicians are taking a lot of money from vulnerable people and their families, despite not offering a science-based approach.

Unfortunately, this fits in neatly with a longstanding problem in the broader world of addiction-treatment services: As journalists like Maia Szalavitz have pointed out, this is an under-regulated area of treatment that is rife with pseudoscience and abuse. To take just one example, Science of Us, drawing on reporting by Sarah Beller, noted in June that one court-ordered addiction-treatment regime draws heavily from nonsensical Scientology ideas. If AASECT’s statement is any indication, the world of sex-addiction “treatment” isn’t all that much better.

Many women use terms such as ‘failure’ or ‘freak’ to describe themselves

By Teresa Bergin

Vaginismus is often a problem from the start of a woman’s sexual life but for some it is a secondary problem, developing even though there may have been previous positive sexual experiences

Vaginismus is a very common but rarely discussed problem. Most women I see with this difficulty will not have discussed it with anyone else, not even female members of their own family or girlfriends. The silence that surrounds the issue and the sense of shame experienced sometimes serves to compound the difficulty itself. Many women with whom I have worked will use terms such as “failure” or “freak” to describe themselves, wishing they were “normal” just like every other woman.

Before seeking therapy, they will often have suffered this distress over a long period of time, not feeling able to embark on or enjoy sexual relationships. The thought that they may not be able to conceive through intercourse is frequently a huge anxiety for these women.

What is vaginismus?
Vaginismus occurs when the muscles around the entrance to the vagina involuntarily contract. It is an automatic, reflexive action; the woman is not intending or trying to tighten these muscles, in fact it is the very opposite of what she is hoping for. Often it is a problem right from the start of a woman’s sexual life but for some it is a secondary problem, developing even though there may have been previous positive sexual experiences. In most cases, the woman is unable to use tampons or have a smear test.

What are the symptoms?
The main symptom of vaginismus is difficulty achieving penetration during intercourse and the woman will experience varying degrees of pain or discomfort with attempts. Partners often describe it like “hitting a wall”. This is as a result of spasm within the very strong pelvic floor or pubococcygeus muscle group. Spasm or tightening may also occur in the lower back and thighs.

What are the causes?
Vaginismus is the result of the body and mind developing a conditioned response to the anticipation of pain. This is an unconscious action, akin to the reflexive action of blinking when something is about to hit our eye. This aspect of vaginismus is one of the most distressing for women as they really want their bodies to respond to arousal and yet find it impossible to manage penetrative sex. The more anxious they become, the less aroused they will feel and the entire problem becomes a vicious cycle.

Vaginismus can occur as a result of psychological or physical issues. Often it is a combination of both. Psychological issues centre around fear and anxiety; worries about sex, performance, negativity about sex from overly rigid family or school messages.

Inadequate sex education is often a feature in vaginismus, resulting in fears about the penis being able to fit or the risk of being hurt or torn. There can also be anxiety about the relationship, trust and commitment fears or a difficulty with being vulnerable or losing control.

Occasionally a woman may have experienced sexual assault, rape or sexual abuse and the trauma associated with these experiences may lead to huge fears around penetration. There are physical causes too – the discomfort caused by thrush, fissures, urinary tract infections, lichens sclerosis or eczema and the aftermath of a difficult vaginal delivery can all trigger the spasm in the PC muscles. Menopausal women can sometimes experience vaginismus as a result of hormonal-related vaginal dryness.

Treatment
Vaginismus is highly treatable. Because every woman is different, the duration of therapy will vary but, with commitment to the therapy process, improvement can be seen quite rapidly. Therapy is a combination of psychosexual education, slow and measured practice with finger insertion and/or vaginal trainers at home and pelvic floor exercises. Women with partners are encouraged to bring them along to sessions so that the therapist can work with them as a couple towards a successful attempt at intercourse.

Vaginismus can place huge stresses on a couple’s relationship as well as their sexual life; therapy can help the couple talk about and navigate these stresses. This is particularly important for a couple wishing to start a family.

What do I do if I think I have vaginismus?
Make an appointment with the GP. It will be helpful to have an examination to out rule any physical problem and have it treated if necessary. The GP is likely to refer you to a sex therapist, a psychotherapist who has specialised in sex and relationships through further training. They have specific expertise in working with this problem on a regular basis. You can also refer yourself to a sex therapist but, because of the very complex and sensitive nature of sex and sexuality, it is important to ensure that they are qualified and accredited. Sex therapists in Ireland may be found on www.cosrt.org.uk

GEMMA’S STORY
Robert was my first boyfriend. We waited six months to try sex, mostly because I was a virgin and very nervous. My mother had always warned me about not getting pregnant and I think I was too scared to try. When we did try, it didn’t work, it was disastrous. We tried again and again but he could not get in.

Every time we tried, I ended up in tears and over time I started to avoid sex. Robert was really patient but I know that it was very tough for him and I felt guilty. We thought it was a phase and it would improve with time. It didn’t stop us getting engaged because we knew we were right for each other.

Eventually I got the courage up to go to the doctor who diagnosed vaginismus – the relief of having a name to put on it was huge. She referred me to a sex therapist. I was embarrassed even talking about it, but quite honestly it was a relief to finally discuss it all. She explained everything about my problem and started me practising with vaginal trainers. I even got to start using tampons, something I never thought I would be able to do.

Robert also came to the sessions and that was a big help. We were given exercises to do at home together that helped me relax a lot. I made a lot of progress over a couple of months and, finally, last Christmas we got to try intercourse again. Success! Our sexual relationship is completely different now, no more worries and lots more fun.

The job of raising children entails a comprehensive, albeit exhausting, list of responsibilities. The duty is a privilege but the pressure to “get it right” weighs heavily on me, particularly when it comes to sex. Considering my own salty experiences, consent isn’t just an important topic, it’s the most important topic — with both my daughter and my son. While I try to remain an open book, there are things I haven’t been teaching when I talk about consent, especially with my daughter and mostly because I’ve been afraid of getting “too deep” into the subject of sex. However, and arguably now more than ever, I need to “dig deep” and have these important conversations.

The first time I had sex I was a junior in high school, and while there was consent I had a few traumatizing experiences years prior that, to this day, I’m not completely “over.” With divorced parents in and out of relationships and my life completely devoid of comprehensive sex education or much, you know, “notice,” it took the whole “live and learn” motto to to an extreme and simply tried to understand sex, sexuality and consent as best I could.

My daughter must, and I mean must, realize how difficult it is, so it doesn’t come as a surprise to her when and/or if she is faced with a decision and the need to protect her voice and her body.

I’d never been taught much about consent or that it’s my right to decide what happens (or doesn’t happen) to my body. I grew up within the bounds of massive chaos that didn’t allow me to decide, even if I had known. Sexualized at a tender age due to a body that matured early, I’d become used to catcalls and looks from strange men. Eventually, I was assaulted by people I trusted; once on a basement floor and a second time in a parking garage. Both events changed me in ways I could never see coming, especially as a parent and partner.

I didn’t tell anyone about either of the incidents. I felt ashamed and thought no one would believe me. If they had, I surmised I’d hear things like, “You asked for it,” or, “I thought you liked him,” all of which would’ve only added to the discomfort I already felt in my skin. Rape culture is a powerful thread, woven deep into the fibers of society. As women, it erases our beliefs that we are worthy, we can say no, and, more importantly, we can change our mind if we’d said yes.

For this reason, and many others, I started talking to my children early on about consent and why it’s so important. By telling them they don’t have to hug someone goodbye if they don’t want to, and setting personal boundaries within our bodies and others, I laid a foundation (I hope) that will aid them both — and especially my daughter — if they’re faced with similar circumstances later on. I want my daughter to know, her body, her rules and that her voice matters.

When I think back to those times I went through after the assaults, I’m saddened. Not only did they morph the way I felt about sex from then on, they changed my views on relationships in general. I don’t mean for it to affect my every move, but it does. Having your body taken advantage of changes a person. I certainly don’t want my daughter (or son) to ever feel this way so I’ll do whatever I can to protect them or, at the very least, empower them through both my experiences and words.

That means not only teaching my them both about consent, but explaining to my daughter how difficult it can be to withhold consent when you feel uncomfortable. The pressure to make people — especially men — happy when you’re a woman is unfathomable to those who do not experience it. So many women (and men) stay silent, for fear they will be judged or ridiculed or put in a physically unsafe situation. My daughter must, and I mean must, realize how difficult it is, so it doesn’t come as a surprise to her when and/or if she is faced with a decision and the need to protect her voice and her body.

With the way society sexualizes women, it’s easy to feel powerless in any sexual situation.

One thing I didn’t know then, was that my silence was not consent. I thought by not agreeing or disagreeing, everything was OK, no matter how much I screamed inside of my head. This is so wrong. I’ve taught my daughter this and hope she utilizes the knowledge she’s in control of her body.

With the way society sexualizes women, it’s easy to feel powerless in any sexual situation. Now that these talks are more prevalent (thanks to an uprising in news stories), the one thing we’re not teaching out daughters when we talk about consent is that very right to change her mind whenever she so chooses, no matter how difficult or embarrassing it may be. If I teach her nothing else, I hope this embeds in her subconscious. It could mean the all difference in the world.

Parenting has challenged me every single day since my early days of pregnancy and I’m beyond grateful for those difficulties. In the end, they’ve helped me evolve in ways I otherwise wouldn’t have, and have opened my eyes to all the things I didn’t know when I was a child that I now fight to know for my own children.

When I look into my daughter’s eyes, I’m fully aware of the gravity consent brings. I want her to know all her options before she’s in a situation she can’t get out of. I want her to know how difficult and uncomfortable it can be to exercise any of those options, because peer pressure is powerful and social expectations are palpable. She can say yes, she can say no, and she can damn well change her mind whenever she damn well pleases.

Sex education varies greatly from school to school, location to location – some places don’t teach it at all, while others teach abstinence only; some schools are much more thorough in terms of discussing safe sex and birth control. I went to Catholic elementary school, and I remember getting a textbook called Gifts and Promises, a few awkward anatomical diagrams, and dire warnings about ruined lives and sin. That was more than two decades ago, so I don’t know how the program may have changed since then, but there has been some encouraging news lately about public schools introducing increasingly comprehensive programs that address issues of consent and safety, as well as same-sex relationships and non-binary gender identities.

Then there’s sex ed in France. According to researcher Odile Fillod, the system has a lot of room for improvement, especially when it comes to the female anatomy. She’s not the only one who thinks so – in June, Haut Conseil à l’Egalité (High Council for Equality), a government organization dedicated to issues of gender equality, published a report indicating that sex education in France is still full of woefully outdated and sexist ideas. The information – or lack thereof – about one particular female organ especially concerns Fillod.

She turned to Melissa Richard, mediator of the Carrefoure Numérique Fab Lab at the Cité des Sciences et de l’Industrie in Paris, who took to Blender to create a 3D model of an organ that remains a mystery to many, and one that’s still given little mention in many sex ed programs: the clitoris.

“The idea came as part of the preparation of videos dealing with non-sexist way of themes SVT program about sex and sexuality,” says Fillod. “In textbooks, the clitoris is often overlooked and is systematically misrepresented when it is. It was therefore able to show concretely what it looks like to talk about sexual anatomical and physiological bases of desire and pleasure remembering women, for once.”

Fillod has been working with V’idéaux, a Toulouse-based documentary film production company, to create a Ministry of Education-supported website dedicated to the promotion of respect and equality between men and women. V’idéaux wanted to include a video about the clitoris on the website, which is set to launch in January 2017, and Fillod realized that she could incorporate a film of the 3D design and printing process onto the site. You can see the video, which probably has the most sensual soundtrack you’ve ever heard in a film about 3D design, below:

It took a bit of work to find anatomically accurate drawings of the clitoris to base the 3D model on, showing that Fillod is correct in her assertion that this organ has been a highly misrepresented one. Once Richard had a realistic model designed, it was printed in PLA on a Mondrian 3D printer, and the open source file has been made available – the world’s first open source, 3D printable clitoris, if I’m not mistaken.

Fillod is hoping that 3D printed clitorises will be used by teachers and doctors to learn and teach about the actual structure, dimensions and function of this important part of the female body. Even though France has the reputation of being sexually progressive, Fillod told The Guardian, the focus is still mostly on male sexuality, to the extent that women and girls are largely uneducated about their own bodies.

“It’s important that women have a mental image of what is actually happening in their body when they’re stimulated,” she said. “In understanding the key role of the clitoris, a woman can stop feeling shame, or [that she’s] abnormal if penile-vaginal intercourse doesn’t do the trick for her – given the anatomical data, that is the case for most women.”

Will 3D printed clitorises start showing up in the classroom? We’ll see…but at least Fillod and Richard have brought some much-needed attention to the often-downplayed and still-taboo subject of female sexuality and pleasure.